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A recent study suggested that primary hyperparathyroidism often is present in patients with thiazide-associated hypercalcemia and that the hypercalcemia usually is mild and nonprogressive in these cases (NEJM JW Gen Med Apr 15 2016 and J Clin Endocrinol Metab 2016; 101:1166). In this new retrospective study, researchers analyzed data on 72 patients with known primary hyperparathyroidism who had serum and urine calcium measurements both before initiation of hydrochlorothiazide (HCTZ) and during an average of 3 years of HCTZ therapy.
Mean serum calcium level was 10.7 mg/dL before HCTZ exposure and did not change significantly during HCTZ therapy. Eleven patients had pre-HCTZ serum calcium levels ≥11.5 mg/dL; after HCTZ was initiated, serum cal…